Open letter to the Health Minister about the proposed vaping regulations
Posted on May 30, 2023 By Colin
FORTY FOUR LEADING TOBACCO CONTROL AND ADDICTION EXPERTS from Australia and New Zealand have written an open letter to Health Minister Mark Butler asking him to reconsider the proposal to further restrict access to nicotine vaping products in Australia.
Their concern is that “this approach will have serious and harmful unintended consequences for public health, will slow the decline in smoking and will ultimately be unsuccessful”
The letter can be read here, and the full list of signatories is at the end of this blog.
Likely outcomes of a crackdown
According to the letter, the likely outcomes of the proposed crackdown are that "the black-market will continue to import and supply unregulated products to adults and young people, people who smoke will have difficulty accessing a far safer alternative and some former smokers who currently vape will return to smoking".
They believe that significant uptake of the prescription model by doctors and consumers is unlikely even though the Minister has eased availability somewhat by allowing all doctors to prescribe. However, it will still be difficult to access vaping products legally, especially compared to obtaining cigarettes.
"History has shown that harsh restrictions and prohibition of drugs rarely work and that the only way to eliminate a black market is to replace it with a legal, regulated market" they say.
How should vaping be regulated?
The experts say that "a well-designed adult consumer regulatory model is most likely to achieve the two goals we all seek, i.e., making vaping products available as a quitting aid for adults who smoke and minimising access by young people"
There is good evidence that vaping is strongly associated with accelerated declines in smoking rates in adults and young people in countries where it is easily available, such as New Zealand and the United Kingdom.
The model that they recommend is widely supported by leading, independent organisations overseas, including the UK Royal College of Physicians, Public Health England (now OHID), the UK National Institute for Clinical Excellence, the New Zealand Ministry of Health and Health Canada.
What about young people?
The experts agree that measures to protect non-smoking youth are essential, “but excessive regulation that makes vaping less accessible, less appealing, more expensive or less effective perpetuates adult smoking and increases smoking-related death and illness”
Young people should not vape or smoke, but the harms from youth vaping are exaggerated. The research shows that vaping by young people who have never smoked is very uncommon in countries where the data are available. Most vaping by never-smokers is occasional and short-term and there is little evidence of harm to health so far.
Nicotine dependence in this group is also very uncommon. Importantly, rather than being a gateway effect to smoking, there is compelling evidence that vaping is diverting young people away from smoking overall.
Young adults have the highest vaping rates, but smoking is declining faster in this age group than the rest of the population and vaping is likely contributing to this.
Flawed Australian reports
The letter draws the Minister’s attention to two flawed Australian government-commissioned reports which are being used to guide policy. “The reports by the National Health and Medical Research Centre (NHMRC) and the Banks report from Australian National University have been critiqued in peer-reviewed journals and have been demonstrated to contain serious scientific errors, misinformation and bias. In our view, the reports are not fit for purpose to guide Australian policy” they wrote.
The critique of the NHMRC report can be found here and the critique of the Banks report here.
The letter concludes by saying “we believe the proposed policy is likely to have an overall negative effect on smoking rates and thus on population health as well as Medicare and health-care costs in Australia”
Reference
Open letter to Hon Mark Butler MP, 29 May 2023
Signatories
Dr Colin Mendelsohn
Founding Chairman, Australian Tobacco Harm Reduction Association, Sydney, Australia
Professor Ron Borland
Professor of Psychology - Health Behaviour, School of Psychological Sciences, The University of Melbourne, Victoria, Australia
Emeritus Professor Wayne Hall AM
National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Queensland, Australia
Dr Alex Wodak AM
Emeritus Consultant, Alcohol and Drug Service, St Vincents’ Hospital, Sydney, Australia
Co-signatories
Professor Amanda Baker
Adjunct Professor, National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
Emeritus Professor Robert Beaglehole
Chair, Action on Smoking and Health – Action for Smokefree 2025, Ellerslie, New Zealand
Dr Ruth Bonita
Emeritus Professor, University of Auckland, Auckland, New Zealand
Dr Stephen Bright
Senior Lecturer (Addiction), Edith Cowan University, Joondalup, WA, Australia
Professor Peter Brooks AM
Hon Professor, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville Victoria Australia
Professor Chris Bullen
Professor of Public Health, School of Population Health, The University of Auckland, Auckland, New Zealand
Dr Andrew Byrne
Addictions Physician, Sydney, Australia
Professor David Castle
Consultant Psychiatrist, Hobart, Tasmania, Australia
Professor Kate Conigrave
Addiction Medicine Specialist, Royal Prince Alfred Hospital; Conjoint Professor, Discipline of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
Dr Karen Counter
Tobacco Treatment Specialist, Port Macquarie, Australia
Professor Nick Crofts AM
Professorial Fellow, Nossal Institute, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Professor Ric Day AM
Professor of Clinical Pharmacology, University of New South Wales & St Vincent's Hospital, Sydney, Australia
Professor Paul Dietze
Co-Program Director, Disease Elimination, Burnet Institute, Melbourne, Australia
Professor Kate Dolan
Adjunct Professor, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
Professor Adrian Dunlop
Conjoint Professor, School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
Dr David Helliwell
Addiction Medicine Specialist, Northern NSW LHD, Lismore NSW, Australia
Dr David Jacka
Addiction Medicine Specialist, Monash Health, Melbourne Australia
Dr Joe Kosterich
Chairman, Australian Tobacco Harm Reduction Association, Sydney, Australia
Associate Professor George Laking
Director, Centre for Cancer Research, University of Auckland, Auckland, New Zealand
Professor Nicholas Lintzeris
Conjoint Professor, Specialty Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
Dr Annie Madden AO
Executive Director, Harm Reduction Australia, Sydney, Australia
Professor Lisa Maher AM
Professor and Program Head, Kirby Institute, Faculty of Medicine, University of New South Wales, Randwick, Australia
Associate Professor Victoria Manning
Head of Research and Workforce Development, Turning Point; Associate Professor in Addictions Studies, Monash University, Melbourne, Australia
Dr Kristen McCarter
Lecturer & Clinical Psychologist, School of Psychological Sciences, University of Newcastle, Callaghan, Australia
Associate Professor Mike McDonough
Addiction Medicine Specialist, University of Adelaide, Adelaide, Australia
Professor Adrian Dunlop
Conjoint Professor, School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
Dr David Outridge
A/Head of Drug and Alcohol Department, Central Coast Local Health District, Lake Haven, Australia
Ms Fiona Patten
Former Victorian MP, Carlton North, Victoria, Australia
Mr Garth Popple
Executive Director, We Help Ourselves (WHOS), Director of WHOS International, Sydney, Australia
Evert Rauwendaal
Alcohol and Other Drug Counsellor, St Vincents’ Hospital, Sydney, Australia
Professor Alison Ritter AO FASSA
Professor Director, Drug Policy Modelling Program, University of New South Wales, Sydney, Australia
Dr Fares Samara
Addiction Medicine Specialist, Port Macquarie, Australia
Dr Catherine Silsbury
Addiction Medicine Specialist, Sydney, Australia
Dr Penelope Truman
Senior Lecturer, School of Health Sciences, Massey University, Wellington, New Zealand
Dr Ingrid van Beek AM
Addiction Medicine Specialist, Sydney, Australia
Gino Vumbaca OAM
President, Harm Reduction Australia, Australia
Associate Professor Natalie Walker
Associate Professor in Population Health and Associate Director, Centre for Addiction Research, National Institute for Health Innovation, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Professor Ian Webster AO
Physician, Emeritus Professor of Community Medicine and Public Health, University of New South Wales, Sydney, Australia
Ben Youdan
Director, Action on Smoking and Health, New Zealand